WESTERN STANDARD COLUMN: Reliance on Canadian Health Care May Kill You

Since 2019, SecondStreet.org has been collecting data on patients dying while waiting for services in Canada’s health care system.

One of the stories that inspired this research was Laura Hillier, an 18-year-old girl from Ontario who was battling leukemia. 

Laura was diagnosed with a bone-marrow donor. To finally give her the upper hand in her fight, all she needed was a potentially life-saving surgery. Tragically, she never received it — the system forced Laura to wait more than seven months for treatment. She died in 2016. Our health care system let her down.

After hearing this heartbreaking story, SecondStreet.org wondered — how many other Canadians were dying before they could get the health care they needed? Was this simply a devastating one-off, or was this part of a larger, national story where people were falling through the cracks of our government-run health care system. 

Unfortunately, the answer is now clear. 

Since 2018, government data collected by SecondStreet.org shows there have been nearly 75,000 waiting lists deaths. This figure covers a wide array of procedures — everything from heart operations and cancer treatment, to procedures which could have improved a patient’s quality of life during their final years… things like cataract surgery and hip operations. 

Unfortunately, it’s difficult to calculate an accurate total as many health regions simply don’t track the data. Provincial governments will post online and tell the world if they discover — during a health inspection — that a local restaurant had a mouldy soup can in their fridge. But track how many patients died before receiving treatment? Apparently that’s not a priority. Quelle surprise.

Thus, the figure above is incomplete. Quebec, Newfoundland and Labrador and most of Manitoba did not respond at all, while Saskatchewan and Nova Scotia only provided surgical data, not diagnostic.

Alberta, which used to respond to our requests annually, has since decided to stop tracking the data all together. 

Had complete data been provided, the total above would likely double.

This is a national crisis. 

With an estimated 5.1 million Canadians on wait lists right now, and the Fraser Institute’s recent reporting that health care wait times in Canada are at an all-time high, it’s a crisis that isn’t going to go away. The status quo is letting people down. Instead of learning from the tragic stories of people like Laura, the problem continues. 

One solution that could help is to carefully track the data and disclose the details publicly — including how many patients died after waiting longer than the maximum recommended wait time for life-saving treatment. Nova Scotia used to release such analysis.

Second, Canadian provinces could copy a policy from the European Union called the “Cross Border Directive”. In short, if an EU patient can’t get the health care they need in their country, they have the right to be reimbursed for surgical costs abroad  — up to what their home government would have spent to provide care locally. Instead of waiting years, a Canadian patient could get treated within weeks, at the same cost to taxpayers. A win-win in the clearest sense. 

Rather than wait for the 2024-25 ‘Died on a Waiting List’ report to show this problem isn’t getting better, governments and policy makers should proceed with health reform now. 

Harrison Fleming is the Legislative and Policy Director for SecondStreet.org, a Canadian think tank. 

This column was originally published in The Western Standard on March 6, 2025.

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Prevention – reduce demand in the first place

If Canadians lived healthier lives, we could reduce demand for emergency services, orthopaedic surgeries, primary care and more. 

For instance, if you visit the Canadian Cancer Society’s website, you’ll read that “about four in ten” cancer cases are preventable. The Heart and Stroke Foundation notes that “almost 80 percent of premature heart disease and stroke can be prevented through healthy behaviours.” A similar number of Diabetes cases are also preventable. 

Many joint replacements and visits to ERs and walk-in clinics could also be avoided through healthy living. 

To be sure, not all health problems can be avoided through healthy living – everyday the system treats Canadians with genetic conditions, helps those injured in unavoidable accidents and more.  

But there is an opportunity to reduce pressure on the health care system through Canadians shifting to healthier lifestyles – better diets, more exercise, etc. 

To learn more, watch our Health Reform Now documentary (scroll up) or see this column. 

Partner with non-profits and for-profit clinics

European countries will partner with anyone who can help patients. 

It doesn’t matter if it’s a non-profit, a government entity or a private clinic. What matters is that patients receive quality treatment, in a timely manner and for a competitive price.  

In Canada, governments often delivery services using government-run hospitals instead of seeing if non-profit or private clinics could deliver the services more effectively. 

When governments have partnered with non-profit and private clinics, the results have often been quite good – Saskatchewan, Ontario and British Columbia are just a few examples of where partnerships have worked well. 

Canada should pursue more of these partnerships to reduce wait times and increase the volume of services provided to patients.  

To learn more, watch our Health Reform Now documentary (scroll up) or see the links above. 

Make cross border care more accessible

In Canada, citizens pay high taxes each year and we’re promised universal health care services in return. The problem is, wait times are often extremely long in our health system – sometimes patients have to wait years to see a specialist or receive surgery. 

If patients don’t want to wait long periods, they often have to reach into their own pocket and pay for treatment outside the province or country. 

Throughout the European Union, we also find universal health care systems. But a key difference is that EU patients have the right to go to other EU countries, pay for surgery and then be reimbursed by their home government. Reimbursements cover up to what the patient’s home government would have spent to provide the treatment locally. 

If Canada copied this approach, a patient waiting a year to get their hip operation could instead receive treatment next week in one of thousands of surgical clinics throughout the developed world. 

Governments benefit too as the patient is now back on their feet and avoiding complications that sometimes come with long wait times – meaning the government doesn’t have to treat those complications on top of the initial health problem. 

To learn more, watch our Health Reform Now documentary (scroll up) or this shorter video. 

Legalize access to non-government providers

Canada is the only country in the world that puts up barriers, or outright bans patients from paying for health services locally. 

For instance, a patient in Toronto cannot pay for a hip operation at a private clinic in Toronto. Their only option is to wait for the government to eventually provide treatment or leave the province and pay elsewhere. 

Countries with better-performing universal health care systems do not have such bans. They allow patients a choice – use the public system or pay privately for treatment. Sweden, France, Australia and more – they all allow choice. 

Why? One reason is that allowing choice means some patients will decide to pay privately. This takes pressure off the public system. For instance, in Sweden, 87% of patients use the public system, but 13% purchase private health insurance. 

Ultimately, more choice improves access for patients. 

To learn more, watch our Health Reform Now documentary (scroll up) or watch this short clip on this topic. 

Shift to funding services for patients, not bureaucracies

In Canada, most hospitals receive a cheque from the government each year and are then asked to do their best to help patients. This approach is known as “block funding”. 

Under this model, a patient walking in the door represents a drain on the hospital’s budget. Over the course of a year, hospital administrators have to make sure the budget stretches out so services are rationed. This is why you might have to wait until next year or the year after for a hip operation, knee operation, etc. 

In better-performing universal health systems, they take the opposite approach – hospitals receive money from the government each time they help a patient. If a hospital completes a knee operation, it might receive, say, $10,000. If it completes a knee operation on another patient, it receives another $10,000. 

This model incentivizes hospitals to help more patients – to help more patients with knee operations, cataract surgery, etc. This approach also incentivizes hospitals to spend money on expenses that help patients (e.g. more doctors, nurses, equipment, etc.) rather than using the money on expenses that don’t help patients (e.g. more admin staff). 

To learn more about this policy option, please watch our Health Reform Now documentary (scroll up) or see this post by MEI.